Difference between revisions of "Immunological and protective function of the foreskin"

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The [[foreskin]], like the eyelid, also serves an important protective and hygienic function. The foreskin protects the delicate glans of the [[penis]] and puts the urethra at a distance form its environment, protecting it from foreign contaminants of all kinds while simultaneously shielding the penis from injury. It is a double fold of skin which offers two layers of protection.
 
The [[foreskin]], like the eyelid, also serves an important protective and hygienic function. The foreskin protects the delicate glans of the [[penis]] and puts the urethra at a distance form its environment, protecting it from foreign contaminants of all kinds while simultaneously shielding the penis from injury. It is a double fold of skin which offers two layers of protection.
  
−
Natural secretions of oil are achieved by sebaceous glands which are abound in the foreskin's inner lining, these are not present in the [[glans penis]].<ref name="hyman-brownstein1969">Hyman AB, Brownstein MH. [https://jamanetwork.com/journals/jamadermatology/article-abstract/530842 Tyson's "glands": ectopic sebaceous glands and papillomatosis penis]. ''Arch Dermatol''. 1969 Jan;99(1):31-6.</ref> They are also present in the eye lid and perform the same function in both places. They secrete the oils necessary to keep the glans surface soft, moist, smooth, warm, sensitive, and with a healthy glistening red or purple color. This moisturizer also maintains PH balance, and optimal cleanliness. This is required to keep the surface of the glans healthy and clean via the cleaning effects of mucous secretions. Again, this function is analogous to the eye lid. The glans penis is meant to be an internal organ covered and protected from the outside world.
+
Natural secretions of oil are achieved by sebaceous glands which are abound in the foreskin's inner lining, these are not present in the [[glans penis]].<ref name="hyman-brownstein1969">{{REFjournal
 +
|last=Hyman
 +
|first=A.B.
 +
|last2=Brownstein
 +
|first2=M.H.
 +
|url=https://jamanetwork.com/journals/jamadermatology/article-abstract/530842
 +
|title=Tyson's "glands": ectopic sebaceous glands and papillomatosis penis
 +
|journal=Arch Dermatol
 +
|date=Jan 1969
 +
|volume=99
 +
|issue=1
 +
|pages=31-36
 +
|accessdate=2019-10-20
 +
}}</ref> They are also present in the eye lid and perform the same function in both places. They secrete the oils necessary to keep the glans surface soft, moist, smooth, warm, sensitive, and with a healthy glistening red or purple color. This moisturizer also maintains PH balance, and optimal cleanliness. This is required to keep the surface of the glans healthy and clean via the cleaning effects of mucous secretions. Again, this function is analogous to the eye lid. The glans penis is meant to be an internal organ covered and protected from the outside world.
  
−
In the genitally intact penis the urine stream flushes out the urethra and foreskin of foreign microbes. In healthy individuals, urine is sterile and has a disinfectant quality. Researchers have demonstrated that the swirling action of urine as it rushes through the foreskin flushes it out effortlessly and naturally.<ref name="parkash-jeykumar1973">Parkash S, Jeykumar S, Subramanyan K, Chaudhuri S. [http://www.cirp.org/library/anatomy/parkash/ Human subpreputial collection: its nature and formation]. ''J Urol''. 1973 Aug 110(2):211-2.</ref>
+
In the genitally intact penis the urine stream flushes out the urethra and foreskin of foreign microbes. In healthy individuals, urine is sterile and has a disinfectant quality. Researchers have demonstrated that the swirling action of urine as it rushes through the foreskin flushes it out effortlessly and naturally.<ref name="parkash-jeykumar1973">{{REFjournal
 +
|last=Parkash
 +
|first=S.
 +
|last2=Jeykumar
 +
|first2=S.
 +
|last3=Subramanyan
 +
|first3=K.
 +
|last4=Chaudhuri
 +
|first4=S.
 +
|url=http://www.cirp.org/library/anatomy/parkash/
 +
|title=Human subpreputial collection: its nature and formation
 +
|journal=J Urol
 +
|date=Aug 1973
 +
|volume=110
 +
|issue=2
 +
|pages=211-212
 +
|accessdate=2019-10-20
 +
}}</ref>
  
−
Though urine passes through the foreskin every day, the inner foreskin is remarkably free of urea — a by-product of liver metabolism that is secreted in urine. Studies demonstrate that washings from the foreskin are rich in fructose, acid phosphatase, and mucin, but never urea. It appears that the secretions of seminal vesicles, prostate, and urethral mucous glands, collectively or individually, keep the foreskin clear and clean as well.<ref>Parkash S. Penis: some facts and fancies. ''Journal of Physician's Association 0f Madras'' June 1982: 1-13.</ref>
+
Though urine passes through the foreskin every day, the inner foreskin is remarkably free of urea — a by-product of liver metabolism that is secreted in urine. Studies demonstrate that washings from the foreskin are rich in fructose, acid phosphatase, and mucin, but never urea. It appears that the secretions of seminal vesicles, prostate, and urethral mucous glands, collectively or individually, keep the foreskin clear and clean as well.<ref>{{REFjournal
−
At birth, the foreskin is usually attached to the glans(head) of the penis, akin to how a fingernail is attached to a finger.<ref>Diebert GA. [http://www.cirp.org/library/anatomy/deibert/ The separation of the prepuce in the human penis]. ''Anatomical Record''. 1993 Nov;57(4):387-99.</ref>  
+
|last=Parkash
 +
|first=S.
 +
|title=Penis: some facts and fancies
 +
|journal=Journal of Physician's Association of Madras
 +
|date=Jun 1982
 +
|pages=1-13
 +
}}</ref> At birth, the foreskin is usually attached to the glans (head) of the penis, akin to how a fingernail is attached to a finger.<ref>{{REFjournal
 +
|last=Deibert
 +
|first=G.A.
 +
|author-link=
 +
|title=The separation of the prepuce in the human penis
 +
|url=http://www.cirp.org/library/anatomy/deibert/
 +
|journal=Anatomical Record
 +
|date=Nov 1993
 +
|volume=57
 +
|issue=4
 +
|pages=387-399
 +
|accessdate=2019-10-20
 +
}}</ref>  
  
−
In infancy the foreskin's tubular neck (prepucial orifice) is often long and narrow while the sphincter muscle in the tip of the foreskin keeps its opening closed. This acts as an extension of the urethra.<ref>Hunter RH. [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1249280/pdf/janat00534-0090.pdf Notes on the development of the prepuce]. ''Journal of Anatomy''. 1935 Oct;70(1):6875.</ref> <ref>Glenister TW. A consideration of their process involved in the development of the prepuce in man. ''Br J Urol''. 1956 Sep;28(3):243-9.</ref>  
+
In infancy the foreskin's tubular neck (prepucial orifice) is often long and narrow while the sphincter muscle in the tip of the foreskin keeps its opening closed. This acts as an extension of the urethra.<ref>{{REFjournal
 +
|last=Hunter
 +
|first=R.H.
 +
|url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1249280/pdf/janat00534-0090.pdf
 +
|title=Notes on the development of the prepuce
 +
|journal=Journal of Anatomy
 +
|date=Oct 1935
 +
|volume=70
 +
|issue=1
 +
|pages=6875
 +
|format=PDF
 +
|accessdate=2019-10-20
 +
}}</ref><ref>{{REFjournal
 +
|last=Glenister
 +
|first=T.W.
 +
|title=A consideration of their process involved in the development of the prepuce in man
 +
|journal=Br J Urol
 +
|date=Sep 1956
 +
|volume=28
 +
|issue=3
 +
|pages=243-249
 +
}}</ref>  
 
Together, these properties prevent the entry of contaminants.
 
Together, these properties prevent the entry of contaminants.
  
 
The idea that the foreskin is "dirty" or "unclean" is a scientifically unfounded superstition. The intact penis is naturally clean and maintains a level of hygiene that is optimal when compared to a penis that has been altered by circumcision.  
 
The idea that the foreskin is "dirty" or "unclean" is a scientifically unfounded superstition. The intact penis is naturally clean and maintains a level of hygiene that is optimal when compared to a penis that has been altered by circumcision.  
  
−
In comparison, due to the open wounds and raw bleeding flesh, the circumcised penis needs much more care after circumcision. The surgically externalized glans is dirty rather then clean because of constant exposure to dirt, abrasion and contaminants.<ref name="vanhowe1997">Van Howe RS. [https://onlinelibrary.wiley.com/doi/pdf/10.1046/j.1464-410X.1997.00467.x Variability in penile appearance and penile findings: a prospective study]. ''Br J Urol'' 1997; 80: 776-82.</ref> Circumcised boys are also found to be more likely to develop balanitis, meatitis, coronal adhesions and meatal stenosis.<ref name="vanhowe1997" />
+
In comparison, due to the open wounds and raw bleeding flesh, the circumcised penis needs much more care after circumcision. The surgically externalized glans is dirty rather then clean because of constant exposure to dirt, abrasion and contaminants.<ref name="vanhowe1997">{{REFjournal
 +
|last=Van Howe
 +
|first=R.S.
 +
|author-link=Robert Van Howe
 +
|url=https://onlinelibrary.wiley.com/doi/pdf/10.1046/j.1464-410X.1997.00467.x
 +
|title=Variability in penile appearance and penile findings: a prospective study
 +
|journal=Br J Urol
 +
|date=1997
 +
|volume=80
 +
|pages=776-782
 +
|accessdate=2019-10-20
 +
}}</ref> Circumcised boys are also found to be more likely to develop balanitis, meatitis, coronal adhesions and meatal stenosis.<ref name="vanhowe1997"/>
  
 
== The immunological function of the foreskin ==
 
== The immunological function of the foreskin ==
  
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The foreskin's inner fold and the glans of the penis are comprised of mucous membrane tissue. These are also present in your eyes, mouth, and all other bodily orifices including the female genitals. These are the first line of immunological defensive for the body's orifices. These mucous membranes perform many immunological and hygienic functions.  
+
The foreskin's inner fold and the glans of the penis are comprised of mucous membrane tissue. These are also present in your eyes, mouth, and all other bodily orifices including the female genitals. These are the first line of immunological defensive for the body's orifices. These mucous membranes perform many immunological and hygienic functions.  
−
Certain components such as [[Langerhans cells]],<ref>Weiss GN, Sanders M, Westbrook KC. [https://www.ncbi.nlm.nih.gov/pubmed/16828878 The distribution and density of Langerhans cells in the human prepuce: site of diminished immune response?] ''Isr J Med Sci'' 1993 Jan;29(1);42-3</ref> plasma cells,<ref name="flower1983" >Flower PJ, Ladds PW, Thomas AD, Watson DL. [https://journals.sagepub.com/doi/abs/10.1177/030098588302000206 An immunopathologic study on the bovine prepuce]. ''Vet Pathol'' 1983 Mar;20(2):189-201.</ref> apocrine glands,<ref> Ahmed A, Jones AW. [https://www.academia.edu/5687437/APOCRINE_CYSTADENOMA_A_REPORT_OF_TWO_CASES_OCCURRING_ON_THE_PREPUCE Apocrine Cystadenoma: a report of two cases occurring on the prepuce]. ''Br J Dermatol'' 1969 Dec; 81(12):899-901.</ref> and sebaceous glands,<ref>Hyman AB, Brownstein MH. Tyson's "glands": ectopic sebaceous glands and papillomatosis penis. ''Arch Dermatol'' 1969 Jan;99(1):31-6</ref> <ref>Delbanco E. Über das gehäufte Aufreten von Talgdrusen an der Innerflähe des Präputium. ''Monatshefte für praktishe Dermatologie'' 1904; 38:536-8.</ref> <ref>Piccinno R, Carrel C-F, Menni S. ''et al''. sebacous glands mimicking molluscum contagiosum ''Acta Derm Venerol'' 1990;70:344-5.</ref> <ref>Krompecher St. Die Histologie der Absonderung fur Smegma Praeputi. ''Anatomischer Anzeiger'' 1932; 75:170-76.</ref>, collectively secrete emollient lubricants.<ref name="parkash-jeykumar1973" /> Apocrine glands perform a crucial function by secreting enzymes such as lysosomal enzymes, cathepsin B, chymotrypsin, and neutrophil elastase.<ref>Frohlich E Shamburg-Lever G, Klesses C. Immunelectron microscopic localization of cathepsin B in human apocrine glands. ''J Cutan Pathol'' 1993 Feb;20(1):54-60</ref>
 
  
−
There is also some research to suggest that lysozyme may protect against HIV infection.<ref>George Hill. [http://www.cirp.org/library/disease/HIV/hill1/ Summary of evidence that the foreskin and lysozyme may protect against HIV infection]. 7 September 2003.</ref>  
+
Certain components such as [[Langerhans cells]],<ref>{{REFjournal
 +
|last=Weiss
 +
|first=G.N.
 +
|last2=Sanders
 +
|first2=M.
 +
|last3=Westbrook
 +
|first3=K.C.
 +
|url=https://www.ncbi.nlm.nih.gov/pubmed/16828878
 +
|title=The distribution and density of Langerhans cells in the human prepuce: site of diminished immune response?
 +
|journal=Isr J Med Sci
 +
|date=Jan 1993
 +
|volume=29
 +
|issue=1
 +
|pages=42-43
 +
|accessdate=2019-10-20
 +
}}</ref> plasma cells,<ref name="flower1983">{{REFjournal
 +
|last=Flower
 +
|first=P.J.
 +
|last2=Ladds
 +
|first2=P.W.
 +
|last3=Thomas
 +
|first3=A.D.
 +
|last4=Watson
 +
|first4=D.L.
 +
|url=https://journals.sagepub.com/doi/abs/10.1177/030098588302000206
 +
|title=An immunopathologic study on the bovine prepuce
 +
|journal=Vet Pathol
 +
|date=Mar 1983
 +
|volume=20
 +
|issue=2
 +
|pages=189-201
 +
|accessdate=2019-10-20
 +
}}</ref> apocrine glands,<ref>{{REFjournal
 +
|last=Ahmed
 +
|first=A.
 +
|last2=Jones
 +
|first2=A.W.
 +
|url=https://www.academia.edu/5687437/APOCRINE_CYSTADENOMA_A_REPORT_OF_TWO_CASES_OCCURRING_ON_THE_PREPUCE
 +
|title=Apocrine Cystadenoma: a report of two cases occurring on the prepuce
 +
|journal=Br J Dermatol
 +
|date=Dec 1969
 +
|volume=81
 +
|issue=12
 +
|pages=899-901
 +
|accessdate=2019-10-20
 +
}}</ref> and sebaceous glands,<ref>{{REFjournal
 +
|last=Hyman
 +
|first=A.B.
 +
|last2=Brownstein
 +
|first2=M.H.
 +
|title=Tyson's "glands": ectopic sebaceous glands and papillomatosis penis
 +
|journal=Arch Dermatol
 +
|date=Jan 1969
 +
|volume=99
 +
|issue=1
 +
|pages=31-36
 +
|accessdate=2019-10-20
 +
}}</ref><ref>{{REFjournal
 +
|last=Delbanco
 +
|first=E.
 +
|title=Über das gehäufte Auftreten von freien Talgdrüsen an der Innenfläche des Präputiums
 +
|trans-title=About the increased occurrence of free sebaceous glands on the inner surface of the prepuce
 +
|language=German
 +
|journal=Monatshefte für praktische Dermatologie
 +
|date=1904
 +
|volume=38
 +
|pages=536-538
 +
|accessdate=2019-10-20
 +
}}</ref><ref>{{REFjournal
 +
|last=Piccinno
 +
|first=R.
 +
|last2=Carrel
 +
|first2=C.-F.
 +
|last3=Menni
 +
|first3=S.
 +
|etal=yes
 +
|title=sebacous glands mimicking molluscum contagiosum
 +
|journal=Acta Derm Venerol
 +
|date=1990
 +
|volume=70
 +
|pages=344-345
 +
}}</ref><ref>{{REFjournal
 +
|last=Krompecher
 +
|first=St.
 +
|title=Die Histologie der Absonderung des Smegma praeputii
 +
|trans-title=Histology of allocation of a smegma praeputii
 +
|language=German
 +
|journal=Anatomischer Anzeiger
 +
|date=1932
 +
|volume=75
 +
|pages=170-176
 +
}}</ref>, collectively secrete emollient lubricants.<ref name="parkash-jeykumar1973"/> Apocrine glands perform a crucial function by secreting enzymes such as lysosomal enzymes, cathepsin B, chymotrypsin, and neutrophil elastase.<ref>{{REFjournal
 +
|last=Frohlich
 +
|first=E.
 +
|last2=Shamburg-Lever
 +
|first2=G.
 +
|last3=Klesses
 +
|first3=C.
 +
|title=Immunelectron microscopic localization of cathepsin B in human apocrine glands
 +
|journal=J Cutan Pathol
 +
|date=Feb 1993
 +
|volume=20
 +
|issue=1
 +
|pages=54-60
 +
}}</ref>  
  
−
Apocrine glands also produce cytokine,<ref>Ahmed AA, Nordlind K, Schultzberd M, Liden S. [https://link.springer.com/article/10.1007%2FBF01105803 Immunohistochemical localization of IL-1 alpha-, IL-1 beta-, IL-6- and TNF-alpha-like immunoreactivities in human apocrine glands]. ''Arch Dermatol Res''. 1995;287(8):764-6.</ref> which is a very important non-antibody protein that generates immune response when in contact with specific agents. Plasma cells which increase in number in response to pathogens levels, secrete immunoglobulin.<ref name="flower1983" />
+
There is also some research to suggest that lysozyme may protect against HIV infection.<ref>{{REFweb
−
It is also very important to note that Langerhans cells that are present in the foreskin produce ''Langerin'', a substance that has been proven to kill human immunodefiency viris (HIV) on contact.<ref> de Witte L, Nabatov A, Pion M, ''et al''. [http://www.cirp.org/news/healthday2007-03-05/ Langerin is a natural barrier to HIV-1 transmission by Langerhans cells]. ''Nat Med'' 2007 Mar;13(3):367-71.</ref>
+
|first=George
 +
|last=Hill
 +
|author-link=George Hill
 +
|url=http://www.cirp.org/library/disease/HIV/hill1/
 +
|title=Summary of evidence that the foreskin and lysozyme may protect against HIV infection
 +
|date=2003-09-07
 +
|accessdate=2019-10-20
 +
}}</ref>  
  
−
All of these function to sequester and “digest” foreign pathogens. All these substances play an important role in protecting the penis from viral and bacterial pathogens. The immunological functions of the human prepuce have been extensively documented by respected researchers for quite some time.<ref>Fleiss PM, Hodges FM, Van Howe RS. [http://www.cirp.org/library/disease/STD/fleiss3/ Immunological functions of the human prepuce]. ''Sex Trans Infect'' (London), Volume 74, Number 5, Pages 364-367, October 1998.</ref>
+
Apocrine glands also produce cytokine,<ref>{{REFjournal
 +
|last=Ahmed
 +
|first=A.A.
 +
|last2=Nordlind
 +
|first2=K.
 +
|last3=Schultzberd
 +
|first3=M.
 +
|last4=Liden
 +
|first4=S.
 +
|url=https://link.springer.com/article/10.1007%2FBF01105803
 +
|title=Immunohistochemical localization of IL-1 alpha-, IL-1 beta-, IL-6- and TNF-alpha-like immunoreactivities in human apocrine glands
 +
|journal=Arch Dermatol Res
 +
|date=1995
 +
|volume=287
 +
|issue=8
 +
|pages=764-766
 +
|accessdate=2019-10-20
 +
}}</ref> which is a very important non-antibody protein that generates immune response when in contact with specific agents. Plasma cells which increase in number in response to pathogens levels, secrete immunoglobulin.<ref name="flower1983"/>
 +
It is also very important to note that Langerhans cells that are present in the foreskin produce ''Langerin'', a substance that has been proven to kill human immunodefiency viris (HIV) on contact.<ref>{{REFjournal
 +
|last=de Witte
 +
|first=L.
 +
|last2=Nabatov
 +
|first2=A.
 +
|last3=Pion
 +
|first3=M.
 +
|etal=yes
 +
|url=http://www.cirp.org/news/healthday2007-03-05/
 +
|title=Langerin is a natural barrier to HIV-1 transmission by Langerhans cells
 +
|journal=Nat Med
 +
|date=Mar 2007
 +
|volume=13
 +
|issue=3
 +
|pages=367-371
 +
|accessdate=2019-10-20
 +
}}</ref>
 +
 
 +
All of these function to sequester and “digest” foreign pathogens. All these substances play an important role in protecting the penis from viral and bacterial pathogens. The immunological functions of the human prepuce have been extensively documented by respected researchers for quite some time.<ref>{{REFjournal
 +
|last=Fleiss
 +
|first=P.M.
 +
|author-link=Paul M. Fleiss
 +
|last2=Hodges
 +
|first2=F.M.
 +
|author2-link=Frederick M. Hodges
 +
|last3=Van Howe
 +
|first3=RS
 +
|author3-link=Robert Van Howe
 +
|url=http://www.cirp.org/library/disease/STD/fleiss3/
 +
|title=Immunological functions of the human prepuce
 +
|journal=Sex Trans Infect (London)
 +
|volume=74
 +
|issue=5
 +
|pages=364-367
 +
|date=Oct 1998
 +
|accessdate=2019-10-20
 +
}}</ref>
  
 
<!--In infancy, simple sugars in breast milk, like antibacterial oligosaccharides, are acquired from the mother's milk and excreted in urine. University studies have shown that these substances cling to the mucosal lining of the inner foreskin and protect against urinary tract infections,<ref>Hanson LA, Karlsson B, Jalil F, ''et al''. Antiviral and antibacterial factors in human milk. In: Hanson LA, ed. ''Biology of Human Milk''. New York Raven Press; 1988. pp. 141-57</ref> as well as infections in other parts of the body.<ref>Coppa GV, Gabrielli O, Giorgi P, Catassi C, Montanari MP, Veraldo PE, Nichols BL. Preliminary study of breast feeding and bacterial adhesion to uroepithelial cells. ''Lancet'' 1990 Mar 10;335(8689):569-71.</ref> Babies excrete in their urine about 300-500 milligrams of oligosaccharides each day. These compounds prevent virulent strains of ''Escherichia coli'' from adhering to the mucosal lining of the entire urinary tract, including the foreskin and glans. For these reasons breast-milk is highly efficacious at preventing UTI.<ref>Gothefors L, Olling S, Winberg J. Breastfeeding and biological properties of faecal ''E. coli'' strains. ''Acta Paediatr Scand'' 1975 Nov;54(6):807-12.</ref> Rigorous studies have repeatedly demonstrated that breast feeding protects against urinary tract infections.<ref>Mårild S. Breastfeeding and Urinary Tract Infections. ''Lancet'' 1990;336:942.</ref> <ref>Pisacane A, ''et al''. Breastfeeding and urinary tract infection. ''The Lancet'', July 7, 1990, p50 </ref> <ref>Pisacane A, Graziano L, Mazzarella G, ''et al''. Breast-feeding and urinary tract infection. ''J Pediatr'' 1992;120:87-89.</ref>
 
<!--In infancy, simple sugars in breast milk, like antibacterial oligosaccharides, are acquired from the mother's milk and excreted in urine. University studies have shown that these substances cling to the mucosal lining of the inner foreskin and protect against urinary tract infections,<ref>Hanson LA, Karlsson B, Jalil F, ''et al''. Antiviral and antibacterial factors in human milk. In: Hanson LA, ed. ''Biology of Human Milk''. New York Raven Press; 1988. pp. 141-57</ref> as well as infections in other parts of the body.<ref>Coppa GV, Gabrielli O, Giorgi P, Catassi C, Montanari MP, Veraldo PE, Nichols BL. Preliminary study of breast feeding and bacterial adhesion to uroepithelial cells. ''Lancet'' 1990 Mar 10;335(8689):569-71.</ref> Babies excrete in their urine about 300-500 milligrams of oligosaccharides each day. These compounds prevent virulent strains of ''Escherichia coli'' from adhering to the mucosal lining of the entire urinary tract, including the foreskin and glans. For these reasons breast-milk is highly efficacious at preventing UTI.<ref>Gothefors L, Olling S, Winberg J. Breastfeeding and biological properties of faecal ''E. coli'' strains. ''Acta Paediatr Scand'' 1975 Nov;54(6):807-12.</ref> Rigorous studies have repeatedly demonstrated that breast feeding protects against urinary tract infections.<ref>Mårild S. Breastfeeding and Urinary Tract Infections. ''Lancet'' 1990;336:942.</ref> <ref>Pisacane A, ''et al''. Breastfeeding and urinary tract infection. ''The Lancet'', July 7, 1990, p50 </ref> <ref>Pisacane A, Graziano L, Mazzarella G, ''et al''. Breast-feeding and urinary tract infection. ''J Pediatr'' 1992;120:87-89.</ref>
 +
 
Researchers have shown that premature foreskin retraction can expose the penis to hospital strains of Escherichia coli and can result in UTI.<ref>Winberg J ''et al''. The prepuce: A mistake of nature? ''Lancet'' 1989, pp.598-99.</ref> Hence the protective function of the foreskin is in the child's best interest, especially during chemically treated diaper wearing years where feces mixed with urine can not only contaminate the permanently exposed urinary meatus but also the amputation wound from the circumcision surgery itself.
 
Researchers have shown that premature foreskin retraction can expose the penis to hospital strains of Escherichia coli and can result in UTI.<ref>Winberg J ''et al''. The prepuce: A mistake of nature? ''Lancet'' 1989, pp.598-99.</ref> Hence the protective function of the foreskin is in the child's best interest, especially during chemically treated diaper wearing years where feces mixed with urine can not only contaminate the permanently exposed urinary meatus but also the amputation wound from the circumcision surgery itself.
  
 
It is important to note that women have a higher risk of UTI. This is because the shorter urethra offers less protection via the immunological function of the urethra's mucosal lining. By the same observation we see that the tubular tip of the foreskin and its mucosal lining act as an extension of the urethra, hence providing more of that same protection via mucosa immunology and the adherence of antibacterial substances in breast milk. Understandably, removal of the foreskin destroys all this functionality.-->
 
It is important to note that women have a higher risk of UTI. This is because the shorter urethra offers less protection via the immunological function of the urethra's mucosal lining. By the same observation we see that the tubular tip of the foreskin and its mucosal lining act as an extension of the urethra, hence providing more of that same protection via mucosa immunology and the adherence of antibacterial substances in breast milk. Understandably, removal of the foreskin destroys all this functionality.-->
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Revision as of 18:23, 20 October 2019

Although it was once claimed that the human foreskin was filthy and harbored disease and infection, in reality the opposite is true. The foreskin is designed by nature to be self cleaning and to provide significant natural immunological protection against all types of infection.

The protective and hygienic function of the foreskin

The foreskin, like the eyelid, also serves an important protective and hygienic function. The foreskin protects the delicate glans of the penis and puts the urethra at a distance form its environment, protecting it from foreign contaminants of all kinds while simultaneously shielding the penis from injury. It is a double fold of skin which offers two layers of protection.

Natural secretions of oil are achieved by sebaceous glands which are abound in the foreskin's inner lining, these are not present in the glans penis.[1] They are also present in the eye lid and perform the same function in both places. They secrete the oils necessary to keep the glans surface soft, moist, smooth, warm, sensitive, and with a healthy glistening red or purple color. This moisturizer also maintains PH balance, and optimal cleanliness. This is required to keep the surface of the glans healthy and clean via the cleaning effects of mucous secretions. Again, this function is analogous to the eye lid. The glans penis is meant to be an internal organ covered and protected from the outside world.

In the genitally intact penis the urine stream flushes out the urethra and foreskin of foreign microbes. In healthy individuals, urine is sterile and has a disinfectant quality. Researchers have demonstrated that the swirling action of urine as it rushes through the foreskin flushes it out effortlessly and naturally.[2]

Though urine passes through the foreskin every day, the inner foreskin is remarkably free of urea — a by-product of liver metabolism that is secreted in urine. Studies demonstrate that washings from the foreskin are rich in fructose, acid phosphatase, and mucin, but never urea. It appears that the secretions of seminal vesicles, prostate, and urethral mucous glands, collectively or individually, keep the foreskin clear and clean as well.[3] At birth, the foreskin is usually attached to the glans (head) of the penis, akin to how a fingernail is attached to a finger.[4]

In infancy the foreskin's tubular neck (prepucial orifice) is often long and narrow while the sphincter muscle in the tip of the foreskin keeps its opening closed. This acts as an extension of the urethra.[5][6] Together, these properties prevent the entry of contaminants.

The idea that the foreskin is "dirty" or "unclean" is a scientifically unfounded superstition. The intact penis is naturally clean and maintains a level of hygiene that is optimal when compared to a penis that has been altered by circumcision.

In comparison, due to the open wounds and raw bleeding flesh, the circumcised penis needs much more care after circumcision. The surgically externalized glans is dirty rather then clean because of constant exposure to dirt, abrasion and contaminants.[7] Circumcised boys are also found to be more likely to develop balanitis, meatitis, coronal adhesions and meatal stenosis.[7]

The immunological function of the foreskin

The foreskin's inner fold and the glans of the penis are comprised of mucous membrane tissue. These are also present in your eyes, mouth, and all other bodily orifices including the female genitals. These are the first line of immunological defensive for the body's orifices. These mucous membranes perform many immunological and hygienic functions.

Certain components such as Langerhans cells,[8] plasma cells,[9] apocrine glands,[10] and sebaceous glands,[11][12][13][14], collectively secrete emollient lubricants.[2] Apocrine glands perform a crucial function by secreting enzymes such as lysosomal enzymes, cathepsin B, chymotrypsin, and neutrophil elastase.[15]

There is also some research to suggest that lysozyme may protect against HIV infection.[16]

Apocrine glands also produce cytokine,[17] which is a very important non-antibody protein that generates immune response when in contact with specific agents. Plasma cells which increase in number in response to pathogens levels, secrete immunoglobulin.[9] It is also very important to note that Langerhans cells that are present in the foreskin produce Langerin, a substance that has been proven to kill human immunodefiency viris (HIV) on contact.[18]

All of these function to sequester and “digest” foreign pathogens. All these substances play an important role in protecting the penis from viral and bacterial pathogens. The immunological functions of the human prepuce have been extensively documented by respected researchers for quite some time.[19]

References

  1. ↑ REFjournal Hyman, A.B., Brownstein, M.H.. Tyson's "glands": ectopic sebaceous glands and papillomatosis penis. Arch Dermatol. January 1969; 99(1): 31-36. Retrieved 20 October 2019.
  2. ↑ a b REFjournal Parkash, S., Jeykumar, S., Subramanyan, K., Chaudhuri, S.. Human subpreputial collection: its nature and formation. J Urol. August 1973; 110(2): 211-212. Retrieved 20 October 2019.
  3. ↑ REFjournal Parkash, S.. Penis: some facts and fancies. Journal of Physician's Association of Madras. June 1982; : 1-13.
  4. ↑ REFjournal Deibert, G.A.. The separation of the prepuce in the human penis. Anatomical Record. November 1993; 57(4): 387-399. Retrieved 20 October 2019.
  5. ↑ REFjournal Hunter, R.H.. Notes on the development of the prepuce PDF. Journal of Anatomy. October 1935; 70(1): 6875. Retrieved 20 October 2019.
  6. ↑ REFjournal Glenister, T.W.. A consideration of their process involved in the development of the prepuce in man. Br J Urol. September 1956; 28(3): 243-249.
  7. ↑ a b REFjournal Van Howe, R.S.. Variability in penile appearance and penile findings: a prospective study. Br J Urol. 1997; 80: 776-782. Retrieved 20 October 2019.
  8. ↑ REFjournal Weiss, G.N., Sanders, M., Westbrook, K.C.. The distribution and density of Langerhans cells in the human prepuce: site of diminished immune response?. Isr J Med Sci. January 1993; 29(1): 42-43. Retrieved 20 October 2019.
  9. ↑ a b REFjournal Flower, P.J., Ladds, P.W., Thomas, A.D., Watson, D.L.. An immunopathologic study on the bovine prepuce. Vet Pathol. March 1983; 20(2): 189-201. Retrieved 20 October 2019.
  10. ↑ REFjournal Ahmed, A., Jones, A.W.. Apocrine Cystadenoma: a report of two cases occurring on the prepuce. Br J Dermatol. December 1969; 81(12): 899-901. Retrieved 20 October 2019.
  11. ↑ REFjournal Hyman, A.B., Brownstein, M.H.. Tyson's "glands": ectopic sebaceous glands and papillomatosis penis. Arch Dermatol. January 1969; 99(1): 31-36. Retrieved 20 October 2019.
  12. ↑ REFjournal Delbanco, E.. Über das gehäufte Auftreten von freien Talgdrüsen an der Innenfläche des Präputiums [About the increased occurrence of free sebaceous glands on the inner surface of the prepuce] (German). Monatshefte für praktische Dermatologie. 1904; 38: 536-538. Retrieved 20 October 2019.
  13. ↑ REFjournal Piccinno, R., Carrel, C.-F., Menni, S., et al. sebacous glands mimicking molluscum contagiosum. Acta Derm Venerol. 1990; 70: 344-345.
  14. ↑ REFjournal Krompecher, St.. Die Histologie der Absonderung des Smegma praeputii [Histology of allocation of a smegma praeputii] (German). Anatomischer Anzeiger. 1932; 75: 170-176.
  15. ↑ REFjournal Frohlich, E., Shamburg-Lever, G., Klesses, C.. Immunelectron microscopic localization of cathepsin B in human apocrine glands. J Cutan Pathol. February 1993; 20(1): 54-60.
  16. ↑ REFweb Hill, George (7 September 2003). Summary of evidence that the foreskin and lysozyme may protect against HIV infection. Retrieved 20 October 2019.
  17. ↑ REFjournal Ahmed, A.A., Nordlind, K., Schultzberd, M., Liden, S.. Immunohistochemical localization of IL-1 alpha-, IL-1 beta-, IL-6- and TNF-alpha-like immunoreactivities in human apocrine glands. Arch Dermatol Res. 1995; 287(8): 764-766. Retrieved 20 October 2019.
  18. ↑ REFjournal de Witte, L., Nabatov, A., Pion, M., et al. Langerin is a natural barrier to HIV-1 transmission by Langerhans cells. Nat Med. March 2007; 13(3): 367-371. Retrieved 20 October 2019.
  19. ↑ REFjournal Fleiss, P.M., Hodges, F.M., Van Howe, RS. Immunological functions of the human prepuce. Sex Trans Infect (London). October 1998; 74(5): 364-367. Retrieved 20 October 2019.
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